Pad supporting and locating appliance



Sept. 5, 1933. F. J. STUART PAD SUPPORTING AND LOCATING APPLIANCE Original Filed March 8, 1929 2 SheetsSheet 1 INVENTOR. Flank J, Stu art,

ATTORNEY.

Sept. 5, 1933. F J, STUART' 1,925,615

PAD SUPPORTING AND LOCATING APPLIANCE Original Filed March 8, 1929 2 Sheets-Sheet 2 AT'I'ORNEY.

Patented Sept. 5, 1933 stares rarest orrics PAD SUl-TPl)EWING AND LOCATING APPLIANCE Frank Joseph Stuart, St. Louis, Mo.

Application March 8, 1929, Serial No; 345,527 Renewed January 14, 1933 5 Claims.

The invention has for an object to effect im-- provements in pad adjusting, locating and supporting means, and is particularly applicable to use in connection with hernia pads. In one aspect, an object of the invention is to enable the accurate placement by inexperienced persons of a pad to cover an opening in the abdominal wall through which an initial visceral protrusion occurs. It is well understood that superficial or more obvious manifestations of a hernia, even to the patient, will not necessarily indicate the exact location of the internal opening through which the protrusion initially leaves the abdominal cavity, and in many cases where truss pads are adjusted by experts, after they have been removed and replaced by the patient or others, they are not readjusted so as to properlyretain the viscera. In addition, especially where it is not desired to have a pad press with severity upon the hernia, the padrmay become displaced by movements of the patient or otherwise without the patient becoming aware of the fact, and it is an object of my invention to provide means whereby such displacement will be guarded against in a secure'manner. It is also an advantage of the invention that the patient or other persons need never be in doubt as to where to place the retaining pad when it is applied after removal.

It is also an object of my'invention to accomplish a new result by providing. in the locator device ameans also to guard t -e person from abrasion by pad elements or support parts, in a novel way.

A further object of the invention is to provide means whereby as the case improves, the same pad may be adjusted in a novel way to modify its pressure, so as to not impede corrective repair by natural processes, as well as to prevent other objectionable results. Particularly it is aimed to accomplish the foregoing ends by an inexpensive means which will notbe bulky or liable to d rangement or displacement casually. A further object is to provide a simple means of tipping the pad at any required angle, and especiallyso to afford the advisable lift-up, or upward finger-like uplift.

Other objects, advantages and features of in vention reside in the construction, arrangement and combination of parts as will be understood from the following description and accom anying drawings, wherein Figure l is a cross sectional view of an inclined plane of means embodying my invention, shown applied to the person of a patient, the plane of the view being coincident with that of the truss device involved. I p I Figure 2 is a sectional view on the line 2'2 of Figure 1. Figure 3 is a detail of the truss detached. Figure l is a plan of the locator device.

Figure 5 is a view similar to Figure 2 showing the application of my invention at animproved stage of a hernia case.

Figure 6 is an elevationalview of a human figureon which my invention is applied.

Fi ure '2 is a back view of the pad mounting.

Figure 8 is a front view of the pad device complete. i

Figure 9 is a detail of modification and use of the spacer pads.

Figure 10 is a View similar to Figure 9 showing the last named modification applied to the person.

Figure ll is a detail of a modified connection between the member 12 and the back plateof the pad mounting.

Figure 12 shows a further modification of the back plate mounting.

Figure 13 is a detail of the pad 14.

There is illustrated ahernia pad device including a central pad 10, and a mounting part or base plate 11, to whichis afiixed a support or truss 12, which in the present instance comprises a resilient wire or rod bent to a form adapted to extend partly around the body of a person. The'wire or support 12 being aflixed to the pad 10 in such away that the pad ll) may oscillate to an extentto furnish a rotary, or massage-like, movement to continuously and automatically massage the parts to restore to the parts,

through such massage, tone, strength, elasticity sure under strain of the member 12 to draw the pad 10 properly against the hernia. The pad'lO may be constructed in accordance with various practices in the art, but preferably is in. fixed relation to the base plate 11, and may be mounted directly thereon by cement or fastenings. The plate 11 and the pad 10 may be constructed of various materials. Customarily, the pad 10 has been made'oi hard rubber while the plate 11 is formed of hard enamelled wood.

The end of the element 12 is inserted in a suitable bored opening located medially within the plate 11 and opening on the edge, and a cross pin 12 is set crosswise in the plate 11 and through the end of the member 12. In Figure 11 a groove 20 is formed in the outer face of the plate 11 extending radially from adjacent its middle to one edge, and the end of the element 12 is laid in' this groove and its extremity secured pivotally by the cross pin 21. The groove may have a metal lining shaped to limit movement of the element as shown in Figure 12. This construction allows ,a certain rocking action of the mounting allowing it to vary its angular relation to the supported viscera and engaged abdominal parts, facilitating blood circulation and the massage effect fore referred to.

The support or truss parts 12 and 13 may iconform to any usual practice and may be varied as required, or other devices for holding and sup porting the pad in position employed. The plate 11. may be variously shaped, but the simplest form is in a simple planiform plate of oval shape corresponding to the contour of the pad 10. There is shown engaged around the pad a number of annular spacer pad pieces '14, which are formed of moderately thick felt, sponge rubber or other suitable material, one side of which is coated with an adhesive presented toward the plate 11, so that they are allsecured in superposed position .upon the plate and held in fixed relation to the pad 10. The adhesive on the pad 14 is preferably of a kind which is initially adeSiVe, so that these pads may be put in place and secured by merely being introducedaround the pad 10 and pressed into place, the adhesive holdin the first one to the plate 11, and the succeeding ones to the next pad members 14.

There is also shown an annular member 15, comprising part of a locator and stabilizer ele ment, this being formed of a felt or other flexible material of light weight and non-abrasive uality, having one side coated with .an adhesive which may be readily applied to the body of a patient,

and the member 15 is preferably of a substantial thickness, although it does not require to be so thick as the pads 14. It is not a pad, but serves by means of the opening therethrough to receive the projected portion of the pad 10 centered within the annulus 15 removably, and by its ate ta hment to h p rson of the wearer to support the abdomen parts in proper form and position. The annulus 15 is applied to the person and permanently retained so that the openin therein exactly corresponds to the area over the initial visceral egress of the hernia. In the present instance the annulus member 15 has also an integral extension 17 in the form of a long tongue or band adapted to extend from the front wearer at one side, this tongue 17 being also coated with adhesive throughout its length, or at intervals, .so that it may be retained upon the person and act as it were as a revamping or artificial supporting muscle, tending to support and protect the underlying parts, and tending to prevent them from further relaxing and separating. The tongue or band is located in such position that it will lie under the resilient truss member 12, or other corresponding truss device utilized to support the pad 10.

The annulus 15 is also provided two shorter extensions 18 and 19 opposite the tongue 17,

the first extending obliquely upward at an angle of about degrees to the axis of the tongue 1'7, while the second short extension extends downward at a similar angle, both of these short extensions having their bases closely adjacent the axis ofthe tongue-1'7.

portion of the abdomen and over the hip of the In use, the physician having diagnosed a case and properly determined the point of initial egress of the hernia, he arranges one of the devices 15-17 upon the person of the patient with the aperture 16 in proper position over the exit as before indicated, it being suiiioient ordinarly to use an adhesive which by merely pressing the device into proper position will cause it to be there retained with security. A pad 10 with its attached base plate and supporting devices 12-13 is then adjusted upon the person of the patient with the pad 10 projecting into the aperture 16 so as to directl engage the slain of the patient within this opening, excepting for an interposed piece of gauze or other fibrous sheet 22. Before placing the pad, however, a suitable number or" the annular pads 14*, are put in place therearound and pressed toward the plate 11 one after another, the first being pressed against the plate 11 so as to be retained thereon by the adhesive and the others secured against the next preceding pad. The number of these devices will depend upon the extent to which it is desired that the 10 shall be pressed into the superficial tissues over the hernia-and into the hernial opening. Ordinarily, there will be fewer of these pads at the time of initiation of treatment with the pad '10 and truss than will be desirable in later stages of the case. The cushion 13 is adjusted back of the hip, in the neighborhood of the gluteal muscle and element 12 adjustedover the tongue 17.

V The pad 10 will also ordinarily be hollow and apertured on the side at which it is applied to the person, and will be filled with an absorbable rubifacient-carrying emollient. In applying the pad a piece or pieces of gauze or other absorbent fibrous or porous material of suitable thickness is laid first against the skin of the patient over the opening of the annulus 15, and the pad 1o then adjusted against this material. This has the effect of preventing excessive exudation of the emollient from the pad 10, but also to eiiect proper feeding of the emollient through the gauze by capillarity to the tissues adjacent the opening in the pad 10. The gauze also prevents the tissues from engaging in the opening. Such emollient will tend to stimulate the repair or building of tissues there adjacent through acceleration of the blood supply, and cause a healthy development tending to close the hernial orifice. To be more explanatory, the well recognized system of therapy, viz., plaster therapy is utilized through the means of the tongue 17, and extensions 18 and 19, together with the mass spread thereon, which contains rubifacient, and the rubifacient carrying emollient within the pad 10, to accelerate the blood supply through the atrophied parts, to re-invigorate the muscles and tissues, and to restore to them tone, strength, elasticity and resiliency. When the parts are thus restored to normalcy then the hernia orifice will close, and. the viscera will accordingly be retained within the abdominal cavity. The device contributes further to the stimulation of the repair of tissues by a massage efiect inciother movements of the body incident to the conscious activities of the wearer contribute to this effect.

It is to be remembered that abdominal hernia is caused by a relaxation, weakening and consequent. separation of certain muscular fibres and tissues surrounding certain natural openings, in

the abdominal walls, the usual points of occurrence being the inguinal opening; the femoral.

opening and the umbilical opening, Also it is remembered that muscles can be strengthened by application thereto of the proper stimulione of the most common, and perhaps the best form of stimulus, being massage, the next chemical action, thermal action, etc. as will be explained.

The novel construction, application and use of the elements 1 012 of the device therefore produces and furnishes the massage; hence the proper stimuli to the affected muscles tending to curative outcome of the use of my appliance. As progress is effected in the case, it is desirable that the pad 10 shall not press with such force upon the person as was initially required, and. therefore in order to modify its engagement with the body, as time goes on, one after another of additional annular pads 14 are placed around the pad 10 and cemented against the last pad 14 put in place. This has the effect of building up the annular pad around the pad 10, the outermost annular pad. engaging the body without the pad 10 so as to support the pad 10 in less compressive engagement with the body as well as making the pad 10 less capable of embedding in the tissues over the abdomen, and results in permitting more ready growth of tissues around the hernial orifice, so as to permit a faster recovery than would be the case if the pad 10 permanently pressed with the same force that is initially required, which excessive pressure tends to cause an atrophied condition of the tissues, because it diminishes the blood supply. In the final stages of use of the appliance as shown, the annular pads 14 may be built up until they are level with or in a plane with, the face of the pad 10, so that only slight pressure is exerted by the pad 10 upon the body of the patient.

The embodiment of the invention is of course subject to modifications in various directions consistent with the invention, including other means to form a permanent guide upon the body for the placement of a hernia retaining pad, and also including modification in the particular manner of shaping or securing the pads 14 in place around the central pad. The central pad 10 is also adapted to various constructions which are well understood in the art.

As shown in Figures 9 and 10 the spacer pads 14 may be readily adapted in form to peculiar requirements of a case especially where a planiform face on the spacer pad device is not desired.'

Thus, in some instances it is found desirable to effect an uplift of the tissues engaged by the pad assembly, as distinct from the mere pressure of the retained parts in a horizontal direction, or a direction perpendicular to the normal superficial surface of the part of the abdomen which is engaged. In order that the pad may get under and lift the parts to be retained, the outermost or all. of the spacer pads 14 may be trimmed at one side so that while having the maximum thickness from the plate 11 to the topmost pad 14 at one side, on the other a partial. or entire relief of engagement of the pads 14 is effected. The pads 14 being of material easily cut with a knife or scissors, they may be assembled one on top of another before introduction around the pad 10, and the pile trimmed to give it the desired contour at the side which is to be presented against the person. The trimming for one use of this kind gives'a resultant spacer assembly in which the annular spacer pad face is planiform and parallel to the plane of the plate 11 on one side to adjacent its middle then is tapered toward the opposite edge ofthe plate 11, next to which only one thickness or pad 14 is left. If desired to present a smooth face on the spacer pad assembly, the topmost pad 14 may be omitted until'after the trimming, and then put in place without cutting, so that its adhesive-coated side sets against the trimmed edges of the others and the last pad 14 forms a continuous facing for the assembly where it engages the body over the plate 11; also protects the body from contact directly with the plate 11 and bushing within same.

' In-such trimming of the pads 14 as last described, it is of course understood that the part removed shall be at the lower side of the pads 14 and the member 12 may be bent to present the relieved part further inward than it would be held in the normal functioning of the member 12, or the plate 11 rotated on the end of the member 12 and secured so as to attain the desired positioning of the bevelled form of spacer pad.

In consequence of the thickness of the annulus 15, and its capability of preventing the pad 10 from moving out of the aperture 16 as long as the pad is pressed against the person with moderate force, and also in view of the fact that the,

extensions 1819 serve to steady the abdomen and the adjacent abdominal content, the device 151'i may be termed a stabilizer and locator combined.

by the rubifacient which by its stimulative effect causes the heating of the tissues more than ordinarily by reason of the increased circulation of the blood.

It is discretionary to use any approved means to apply heat from an external source.

It is of course understood that the shapes of the various parts may be varied from the particular forms shown to adapt the invention to particular cases or situations. Thus, the openings in the pads 14 may be changed, and the proportions of the pad 10 and its supporting plate 11 modified as desired.

It is to be understood that the aperture 16 in the part 15 serves to center the pad 10 by reason of the thickness of the material 15 being sufficient to obstruct movement of the pad 10 laterally from the opening 16. Should it be found necessary to have a thicker material around the opening 16 to insure the retentive effect, one or more of the washers or pads 14 may be adjusted with the adhesive face next to the element'15 and located so that the aperture through the annular pad 14 will aline with the opening 16 and then pressed against the element 15 so as to secure the part 14 in place on the element 15.

i, In a surgical pad in combination, an annulus fixed on the skin, a pad mounting separate therefrom, and a pad carried thereby engaging the skin within the annulus, and, attachable spacer pads beside and in fixed relation to the retainer pad.

2. A pad device, of the character described comprising a guide annulus fixed upon the body of a patient, a retainer pad, a mounting therefor, said pad engaging the body Within the annulus, and a plurality of attachable annular spacer pads around the first named pad in fixed relation thereto and adapted to engage the body of a patient around the first named pad to hold the said first named mounting pad in predetermined. pressure engagement with the body of the patient.

3. An article of the character described, comprising an annular locator device having an adhesive upon one face, and formed with an innee-acre tegral tongue extension adapted topass from the annulus around the hip of a wearer, and a truss device including a pad support having a member adapted to embrace the body While lying centrally over said extension, and a pad carried thereby adapted to enter the annulus to engage the body of the wearer.

4. The structure of claim 3 in which said pad device includes a plurality of attachable annular pad devices adapted to be fixed around the first named pad. I

5. The structure of claim 3 in which the said pad device includes a central hernia retaining pad and a base plate fixed with respect thereto and a plurality of annular spacer pads-having adhesive upon one side and adapted to be mounted in superposed relation upon said plate as required, for thepurposes described.

FRANK JOSEPH STUART. 

